American Journal of Clinical Medicine Research, 2013, Vol. 1, No. 1, 23-25 DOI:10.12691/ajcmr-1-1-6 An Audit of Uterovaginal Prolapse in Enugu, Southeast Nigeria (original) (raw)
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An Audit of Uterovaginal Prolapse in Enugu, Southeast Nigeria
American Journal of Clinical Medicine Research, 2013
A retrospective study of utero-vaginal prolapse to determine the frequency and determinants of uterovaginal prolapse, degrees and its complications at the University of Nigeria Teaching Hospital (UNTH) between January 1, 2005 and December 31, 2009. The prevalence of uterovaginal prolapse was 3.4%. Thirty three (66%) of them were postmenopausal. Multiparity was a significant determinant as 74% of them were grand-multiparous. The commonest symptom was ‘something coming down the vagina’ in 96% of the study subjects. Second degree prolapse was the commonest type of presentation (48%) and the definitive treatment modality was vaginal hysterectomy with pelvic floor repair (44%). Multiparity, prolonged labour and unsupervised deliveries are significant determinants. Uterovaginal prolapse is primarily a common gynaecological condition of the parous and elderly postmenopausal women associated with a decreased body image and quality of life. Education of women, women empowerment, effective antenatal care, supervised hospital deliveries, and limiting the family size by efficient contraception deserve priority attention to prevent this social malady.
Objective: Uterovaginal prolapse (UVP) as a gynaecological problem is very common especially in multipara. This condition is important to gynaecologists practicing in Sub-Saharan Africa because of its strong link with multiparity, poor conduct of labour, and most importantly, its role as a cause of chronic morbidity in many post-menopausal women necessitating major gynaecological surgeries.. Methods: A retrospective study of utero-vaginal prolapse to determine the prevalence, presentation , management patterns and complications of UVP at the Bowen University Teaching Hospital , Ogbomosho, Oyo State, Nigeria between January 1, 2010 and December 31, 2014. Relevant data were obtained from the case notes, which included age, parity, presenting symptoms, number of living children, types of delivery, types of surgical management and associated operative morbidity and mortality. The data were presented as simple percentages. Results : The prevalence of uterovaginal prolapse was 5.4%. The mean age at presentation was 51.4± 3.3 years. The mean parity was 4.2± 1.6. Fifty-six (90.3%) of them were at least 40 years old. Majority of the patients(80.6%) were grand-multiparous. The commonest symptom was 'something coming down the vagina' in 96% of the study subjects. Difficult labour was found to be the most common associated factor in 47 (76.2%) of the patients Second degree prolapse was the commonest type of presentation (74.2%). The most common form of treatment offered was vaginal hysterectomy with pelvic floor repair, 46 (74.2%) of the patients. Twenty-four (38.7%) patients had vaginal pessaries inserted for various degrees of UVP. Conclusion: Uterovaginal prolapse is a common gynaecological condition of the parous and elderly postmenopausal women associated with a decreased body image and quality of life. Supervised hospital deliveries and limiting the family size by efficient contraception deserve priority attention to prevent this social malady. Résumé Objectif : Le prolapsus utérovaginal (PUV) est un problème gynécologique, très courant particulièrement chez les multipares. Cette condition est très importante pour les gynécologues exerçant en Afrique subsaharienne, due au fait qu'il est fortement lié à la « multiparité », mauvaise conduite de travail, et plus important encore son rôle en tant que cause de morbidité chronique chez plusieurs femmes ayant dépassé la ménopause et nécessitant des interventions chirurgicales gynécologique. Méthodes : Une étude rétrospective du prolapsus utérovaginal pour déterminer la prévalence (fréquence), la présentation, les modèles de gestion et les complications des PUV au centre hospitalier universitaire de
To evaluate the predisposing factors of uterovaginal prolapse in women admitted in gynaecology ward
Indian Journal of Obstetrics and Gynecology Research, 2023
Uterovaginal prolapse is an abnormal protrusion or herniation of pelvic organs from its normal position in the pelvis, due to failure of anatomical support. The prevalence of uterovaginal prolapse is difficult to be determined because many women are asymptomatic and many are hesitant to discuss with family. It can be considered a silent epidemic. The cause of uterovaginal prolapse is multifactorial. The parity, mode of delivery, postmenopausal status, obesity are some of the factors affecting the severity. The condition is preventive and by counseling and care during antenatal and postnatal period, the prevalence of this condition can be curtailed and quality of life can be improved. Aim: To evaluate the predisposing factors of uterovaginal prolapse in women admitted to the gynaecology ward. Materials and Methods: A retrospective study was done for a period of 2 years from January 2019 to January 2021 at Integral Institute of Medical Sciences and Research, a tertiary care hospital and medical college, Kursi Road, Dasauli, Lucknow. The women admitted in gynaecology ward with symptoms of mass per vagina were included in the study. The data was retrieved from medical records of the department. The case file as per inclusion and exclusion criteria was identified and included in the study. The information of risk factors was collected using patient proforma. The pelvic organ prolapse quantification system (POPQ) approved by international continence society was used for categorizing uterovaginal prolapse. Data was analysed using SPSS version 20. Frequencies, percentage and mean computed to describe the variables of the study. The Chi-square test was used to compare variables. The statistical significance P<0.05 was considered significant. Result: The period of study was from January 2019 to January 2021. During this period 11256 patients were seen at the gynaecological clinic, out of which 206 patients had uterovaginal prolapse. The prevalence was 1.8%. Conclusion: The multiparity, prolonged and difficult deliveries, delivery by untrained personnel, mismanaged third stage of labour involving injury to sphincters and vaginal tears are determinants of prolapse uterus. Further postmenopausal condition causing hypoestrogenic state causes weaking of ligaments, collagen and aggravates the condition. Hence, preventive measures like institutional delivery, delivery by trained personnel, menopausal clinics may help the target population. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Clinical Epidemiology of Uterovaginal Prolapse
https://ijshr.com/IJSHR\_Vol.6\_Issue.1\_Jan2021/IJSHR-Abstract.052.html, 2021
Pelvic organ prolapse (POP) is a bulge or protrusion of pelvic organs and their associated vaginal segments into or through the vagina. It affects about 30% of the women between 20-59 years of age. It is a significant public health problem in most developing countries. This prospective observational study was conducted, in the department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and Child, Indira Gandhi Medical College, Shimla, for a period of one year, from 1 st June 2019 to 31 st May 2020. Patients with pelvic organ prolapse were admitted to the ward, a detailed history was recorded in a proforma designed for the study and examination was done. POPQ examination was done.70 patients were admitted in the ward. Majority of the women with prolapse were in age group of age>60 years of age i.e. 60. It was more common with higher parity with para more than or equal to 3 i.e. 60%. POP was observed in 91.1% women who had normal delivery of which 85.7% had home deliveries, 70% of which were conducted by untrained birth attendants, 85.7% women with no episiotomy given.78.57% women had attained menopause. (48.5% of these women resumed work within 15 of delivery. The diversity of symptoms in POP can impact a woman physically, socially, and psychologically and thus affect the quality of life. Thus avoiding its risk factors will go a long way in its prevention.
2021
Background: Uterovaginal prolapse (UVP) is a major women’s health concern throughout the world. Globally, 2-20% of all women are affected by UVP. The mean prevalence of pelvic organ prolapse in developing countries is 19.7%. The prevalence of UVP in Ethiopia is 18.55% among all gynecological operations. UVP is a source of severe morbidity and psychological upheaval to the patient, who is often socially withdrawn and stigmatized. UVP negatively affects socioeconomic and reproductive activity of affected women. It is, therefore, of interest to study its prevalence and factors associated with the condition.Methodology: Institution-based retrospective cross-sectional study was conducted in selected Addis Ababa city governmental hospitals and the medical record charts of women admitted in the respective gynecology wards were reviewed. The medical records included in this study were those from March 2017 to February 2019 G.C. and 400 records of admitted women were randomly selected. The d...
Genital prolapse: a 5-year review at Federal Medical Centre Umuahia southeastern Nigeria
Background: Genital prolapse is an important cause of morbidity among postmenopausal and multiparous women especially in our environment where a high premium is placed on large family size. This study was done to determine the prevalence, risk factors, clinical presentation, and management options of genital prolapse. Patients and Methods: Data of those diagnosed with genital prolapse were retrieved from records in the clinic, wards, theater, and from patients’ folders in the medical records department. Statistical Analysis Used: Data were analyzed using Statistical Package for Social Sciences version 20 with P < 0.05. Results: Genital prolapse accounted for 0.8% of gynecological clinic attendances and 5.2% of major gynecological operations. The mean age of patients was 56.7 ± 15.5 years. Farmers constituted 60.7% of the patients while 72.1% and 70.5% were postmenopausal and grandmultiparous women, respectively. The sensation of something coming down the vagina was the most common symptom noted in 98.4% of the patients. Most (23.0%) of the patients had unsupervised delivery at home. Uterovaginal prolapse was the most common (70.5%) type of genital prolapse, and third‑degree uterovaginal prolapse was its most frequent presentation. Majority of the patients (44.4%) were managed expectantly while the most common surgery performed was vaginal hysterectomy with pelvic floor repair (33.3%). Conclusion: Widespread availability of antenatal services especially in the rural communities and limitation on family size can significantly reduce the burden of this disease
2020
Background: Uterine Prolapse is an important but one of the most neglected public health problems causing maternal morbidity and mortality among women of reproductive age in developing countries including Ethiopia. However, yet few data are available with respect to uterine prolapse. The objective of this study was to assess the prevalence of, and factors associated with uterine prolapse among women of reproductive age. Methods: A community based cross-sectional study was conducted in Loma Woreda, Dawro southwest Ethiopia, from November to December 2019. A total of 422 randomly selected women of reproductive age were participated in the study. Data were collected by face-to-face interview with pre-structured questionnaire and clinical diagnoses were carried out. Epi data 3.2.1 and SPSS version 24 were used for data entry, processing and analysis. Binary Logistic regression was used to nd out the association between dependent and independent variables. Variables with P-value less than 0.25 in bivariate logistic regression were further examined using multivariate logistic regression to investigate an association between dependent variable and independent variables. Results: The mean age of the respondents was 35.4 years (±7.994 SD). This study identi ed that the prevalence of symptomatic and anatomical uterine prolapse was 6.6 %(28) and 5.9%(25) respectively. The prevalence of anatomical prolapse was used as a reference when determining the associated factors. Age at rst marriage (AOR: 0.25, 95%CI (0.07, 0.89), place of delivery (AOR: 3.33, 95%CI (1.21, 9.13), birth attendant assisted delivery (AOR 0.21; 95%CI (0.06, 0.71) and history of abortion (AOR: 2.94, 95%CI (1.08, 7.97) were found to have signi cantly and independently associated with prevalence of uterine prolapse. Conclusion: Uterine prolapse is common among women of reproductive age group age at rst marriage, place of delivery, birth attendant assisted delivery, and history of abortion were found to be independent predictors of prevalence of uterine prolapse. Background Of The Study Uterine prolapse (UP), known as pelvic organ prolapse (POP) and genital prolapse; dropping of uterus from its anatomical con nes to positions within or outside the vaginal introitus, occurs weakened pelvic muscles no longer support the appropriate positioning of pelvic organs, vagina and uterus in particular accompanied by different prolapse symptoms like heaviness or something coming down, and other sexual, urinary, and bowel [1]. UP is most common gynecological health problems contributing to maternal morbidity and mortality among women of reproductive age in developing countries; lead to severe degrees of physical disability; for instance, inability to work, di culties in walking or standing up, di culties in urinating or defecating, painful intercourse, increased social stigma, and economic deprivation also affects physical and mental health of women, and can be fatal if left untreated[1, 2, 4].
Biomolecular and Health Science Journal
Introduction: Uterine prolapse can occurs due to the failure of the ligamentous and fascial supports of the uterus. It causes inconvenience to the patients because of genital tract dysfunction and decrease quality of life. The risk factor are multifactorial. Advancing age, increasing parity, vaginal delivery, and menopause is associated with the uterine risk factors. The aim of this study is to describe the stage, treatment, age, parity, vaginal delivery, and menopause status of women with uterine prolapse in Dr. Soetomo General Academic Hospital, Surabaya. Methods: This research is a descriptive study. The sample is included all women with complaints of uterine prolapse diagnosed and treated at Dr. Soetomo General Academic Hospital, Surabaya from January – December 2017. Statistical was analysed descriptively.Results: From total 82 patients of uterine prolapse in Gynecology Outpatient Clinic Dr. Soetomo General Academic Hospital, Surabaya in 2017, most of the uterine prolapse patie...
Chattagram Maa-O-Shishu Hospital Medical College Journal, 2020
Background : Utero vaginal prolapse is a big health problem in Bangladesh. The aim of this study was to calculate prevalence of uterine prolapse and to find out the possible factors that are responsible for this disease among patients attended at Chattogram General Hospital (250 bedded) Bangladesh. Materials and methods: It was a descriptive study which was done between November 2016 to August 2017. This analysis was restricted to a sample that included all women complaints of uterine prolapse diagnosed and treated at Chattogram General Hospital. Results: During a 10 months period, 100 women were diagnosed and treated with uterine prolapse. The prevalence of utero-vaginal prolapse is 4.2%. The mean age at the time of clinical presentation was 40 years. In average, the women gave birth to four children vaginally. 20% of the women were smokers and 84% of them were postmenopausal. 10% of the affected patients had a Chronic Obstructive Pulmonary Disease (COPD) 41% suffered from hyperten...
International Journal of Women's Health, 2022
To determine the prevalence, clinical stage at presentation and factors associated with pelvic organ prolapse (POP) among women attending the gynecology outpatient clinic at Mbarara Regional Referral Hospital (MRRH), Uganda. Methods: We conducted a cross-sectional study at the gynecology outpatient clinic of MRRH from September 2019 to January 2020. Women aged 18-90 years were systematically sampled and recruited into this study. An interviewer administered questionnaire was used to collect participants' socio-demographic, obstetric, gynecological and medical factors. POP stage was obtained by using the pelvic organ prolapse-quantification system. Multivariable logistic regression analysis was done to determine factors associated with pelvic organ prolapse.